Top Dietary Folate Sources Patient Handout

Top Dietary Folate Sources Patient Handout – Print & Use with Methotrexate MTX

Goal: 400–600 mcg natural folate daily (in addition to folic acid supplement)
1 mcg food folate ≈ 0.6 mcg folic acid (less bioavailable)

HIGH-FOLATE FOODS (>100 mcg per serving)

Food
Serving
Folate (mcg)
Notes
Cooked lentils
½ cup
180
Cheap, versatile
Cooked spinach
½ cup
130
Boil lightly to reduce oxalates
Cooked black beans
½ cup
128
Rinse canned to cut sodium
Asparagus (cooked)
4 spears
85–100
Grill or steam
Avocado
½ medium
80–90
Add to salads
Broccoli (cooked)
½ cup
80
Steam to retain folate
Brussels sprouts
½ cup
75
Roast for flavor

GOOD SOURCES (50–100 mcg per serving)

Food
Serving
Folate (mcg)
Orange
1 medium
50
Fortified cereal
¾ cup
100–400*
Romaine lettuce
2 cups
65
Peas (cooked)
½ cup
50
Papaya
1 cup
55
Banana
1 medium
25

MODERATE SOURCES (20–50 mcg)

Food
Serving
Folate (mcg)
Egg (boiled)
1 large
25
Beef liver
3 oz
215
Sunflower seeds
¼ cup
40
Peanuts
¼ cup
35
Whole wheat bread
1 slice
25

Folate-Friendly Meal Ideas (300–400 mcg total)

Meal
Foods
Folate
Breakfast
Fortified cereal (¾ cup) + orange
200–400 mcg
Lunch
Spinach salad (1 cup raw) + ½ cup chickpeas + avocado
250 mcg
Dinner
Lentil soup (1 cup) + steamed broccoli (½ cup)
260 mcg
Snack
Hummus (2 tbsp) + carrot sticks
50 mcg

Cooking & Storage Tips (Folate is fragile!)

Do ✅
Don’t ❌
Steam or microwave
Over-boil in lots of water
Eat raw or lightly cooked
Store cut greens >2 days
Use cooking liquid (e.g., in soup)
Freeze/thaw repeatedly

Folate + MTX: Key Reminders

  • Food folate does NOT interfere with MTX efficacy (unlike high-dose folic acid).
  • Aim for variety – no need to track exact mcg daily.
  • Avoid “folate-free” diets (e.g., strict keto may limit beans/greens).
  • Alcohol reduces folate absorption – limit to <1 drink/day.

Quick Shopping List
☐ Lentils/beans (canned or dry)
☐ Spinach or kale
☐ Avocado
☐ Oranges
☐ Fortified cereal (low sugar)
☐ Broccoli/asparagus

Sources: USDA FoodData Central, NIH Office of Dietary Supplements – 2025

7-DAY FOLATE-RICH MEAL PLANFor Methotrexate (MTX) PatientsGoal: ~400–600 mcg natural folate daily + folic acid supplement
Print, check boxes, and stick them on your fridge!


MTX Day: ________________ (e.g., Friday)
Folic Acid: 5 mg on ________________ (24–48 h after MTX)
OR 1 mg daily (skip MTX day)


Day
Breakfast (~150 mcg)
Lunch (~200 mcg)
Dinner (~200 mcg)
Snack (~50 mcg)
Daily Total
MON
Fortified cereal (¾ cup, 200 mcg*) + banana
Spinach salad: 1 cup raw spinach + ½ cup chickpeas + ¼ avocado + orange slices
Lentil soup (1 cup) + steamed broccoli (½ cup)
Hummus (2 tbsp) + carrot sticks
~600 mcg
TUE
Greek yogurt + ½ cup strawberries + fortified oatmeal (100 mcg*)
Black bean wrap: ½ cup black beans + lettuce + ¼ avocado in whole-wheat tortilla
Grilled salmon + asparagus (4 spears) + quinoa
Handful peanuts (¼ cup)
~550 mcg
WED
Orange (1) + whole-wheat toast with peanut butter
Chickpea salad: ½ cup chickpeas + cucumber + 1 cup romaine + lemon dressing
Beef stir-fry with Brussels sprouts (½ cup) + brown rice
Boiled egg (1)
~500 mcg
THU
Smoothie: 1 cup spinach + ½ banana + fortified OJ (100 mcg*)
Lentil & veggie soup (1 cup) + whole-grain roll
Chicken + roasted broccoli (½ cup) + sweet potato
Sunflower seeds (2 tbsp)
~580 mcg
FRI (MTX DAY)
Fortified cereal (¾ cup) + ½ cup berries
Avocado toast (½ avocado) on whole-wheat + side salad (1 cup romaine)
Lentil curry (¾ cup) + steamed spinach (½ cup)
Orange segments
~570 mcg
SAT
Scrambled eggs (2) + sautéed spinach (½ cup)
Quinoa bowl: ½ cup quinoa + ½ cup black beans + ¼ avocado
Grilled fish + asparagus (4 spears) + brown rice
Fortified cereal (½ cup dry)
~540 mcg
SUN (Folic Acid Day)
Oatmeal with fortified milk + ½ papaya
Lentil salad: ½ cup lentils + 1 cup mixed greens + orange
Veggie stir-fry: broccoli, Brussels sprouts, peas + tofu
Peanuts (¼ cup)
~620 mcg

Quick Shopping List (Serves 1 person)

Produce
Pantry
Protein
Dairy/Other
☐ Spinach (1 bag)
☐ Lentils (1 can/dry)
☐ Eggs (6)
☐ Fortified cereal
☐ Broccoli (1 head)
☐ Black beans (1 can)
☐ Chicken/salmon
☐ Greek yogurt
☐ Asparagus
☐ Chickpeas (1 can)
☐ Tofu (optional)
☐ Fortified OJ
☐ Avocado (3)
☐ Quinoa
☐ Peanuts/seeds
☐ Oranges (6)
☐ Brown rice
☐ Romaine lettuce
☐ Hummus
☐ Brussels sprouts
☐ Whole-wheat bread/tortilla

Prep Tips (Save Time!)

  • Sunday: Cook 2 cups lentils + 1 cup quinoa → fridge.
  • Daily: Steam veggies (3 min). DO NOT USE MICROWAVE!
  • Folate Boost: Add spinach to eggs, soups, and smoothies for a nutrient-rich addition.

Notes

  • All meals <30 min prep.
  • Calories: ~1,600–1,800 (adjust portions as needed).
  • Vegetarian? Swap meat for beans/tofu.
  • Low appetite on MTX day? Prioritize soup + fortified cereal.

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